Natural and social disasters: racial inequality in access to contraceptives after Hurricane Ike

J Womens Health (Larchmt). 2011 Dec;20(12):1861-6. doi: 10.1089/jwh.2010.2613. Epub 2011 Sep 23.


Background: Few data are available on access to contraception following a natural disaster. The current study extends the literature by examining access to various types of birth control in a large sample of women from diverse backgrounds following Hurricane Ike, which made landfall on September 13, 2008, on the upper Texas Gulf Coast.

Methods: We examined Hurricane Ike's influence on access to contraceptives through survey results from 975 white, black, and Hispanic women 16-24 years of age receiving care at one of five publicly funded reproductive health clinics in the Texas Gulf Coast region between August 2008 and July 2010.

Results: Overall, 13% of women reported difficulties accessing contraception. Black women had more difficulty than their white (p<0.001) and Hispanic (p=0.019) counterparts. Using multivariate analysis, we found that although family planning clinics in the area were open, black women (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.37-3.73; p=0.001] and hurricane evacuees (OR 2.17, 95% CI 1.27-3.72; p=0.005) reported greater difficulty in accessing birth control. Last, we found that a lack of access to birth control was related to having a higher frequency of unprotected sex for women of all races (p=0.001).

Conclusions: Access to resources is critical in differentiating the level of impact of disasters on various groups of people. We suggest a community-based disaster preparedness and response model that takes women's reproductive needs into account.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Black People / statistics & numerical data*
  • Contraception Behavior / ethnology*
  • Disasters*
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Health Status Disparities*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Interpersonal Relations
  • Multivariate Analysis
  • Social Class
  • Social Environment
  • Socioeconomic Factors
  • White People / statistics & numerical data*
  • Young Adult